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Introduction: Chronic intestinal failure (IF) remains as a rare disease, with limited therapeutic alternatives outside of comprehensive multidisciplinary units. Recovery of intestinal sufficiency is the desired outcome; therefore, we aim to present the evolving experience of a single center treating pediatric and adult IF patients. Material and Methods: Retrospective observational study, including all Type III-IF patients, treated at our Intestinal Failure, Rehabilitation and Transplant Unit between January 2006 and October 2020. Age, sex, evolution of treatment alternatives, and achievement of intestinal sufficiency (IS), were analysed. Results: 444 patients with intestinal insufficiency were evaluated in the study period; 347 had Type III-IF. 239 were adults, average age was 49 years (±16), 120 (51%) were women; 17 patients underwent intestinal transplantation (IT), 10 (59%) achieved intestinal autonomy [50% of the ITx were done during the first 3 years of the program]; 108 patients underwent Autologous Gastrointestinal tract Reconstruction surgery (AGIRS), 69 patients (63.8%) achieved IS [50% of the AGIRS were performed in the last 6 years]; from those who underwent AGIRS and failed to rehabilitate, 17 (44%), were started on sGLP-2 analogues since 2014; 11 (64.7%) achieved IS; therefore 80/239 adults (74.1%) achieved IS. From the 108 pediatric patients (mean age: 11 months (±28), 60% male; 28 were transplanted [50% of the ITx were done in the first 2 years of the program]; and 18 gained intestinal autonomy (64%) 15 patients underwent surgical treatment (9 AGIRS and 6 STEP) [50% of the AGIRS and STEP were performed in the last 5 years], 5 (33.3%) achieved IS; from the remaining, 6 underwent treatment with sGLP analogues and 3 (50%) achieved IS. Therefore 53.3% of the paediatric patients achieved IS. Conclusions: Intestinal rehabilitation therapies including surgical techniques, nutritional strategies and enterohormone therapy have evolved and improved overtime. These treatments combined and performed at a multidisciplinary Unit, allow enhanced rehabilitation rates.

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